The results of the meta-analysis demonstrated that paternal support interventions significantly increased the rate of exclusive breastfeeding at various postpartum stages. Notably, interventions targeting fathers within the first three months postpartum markedly increase mothers’ positive inclination toward exclusive breastfeeding. These findings underscore the critical role of fathers in promoting breastfeeding practices. Nevertheless, given that only one of the included studies utilized the six-month breastfeeding rate as an outcome indicator, the role of paternal support in the later stages of breastfeeding remains insufficiently elucidated. Consequently, future research must urgently expand sample sizes, adopt a multicenter design, and extend follow-up periods to facilitate more comprehensive and high-quality investigations.

Multiple studies have demonstrated that proactive paternal intervention in supporting breastfeeding significantly enhances both the success rate and the duration of breastfeeding [8, 15]. As highlighted during World Breastfeeding Week 2024, the concept of “partner sharing facilitates breastfeeding” underscores the importance of actively involving the father of a newborn in the breastfeeding process. This involvement can offer significant behavioral support to the mother, thereby enhancing her confidence in breastfeeding and positively influencing her mental health and self-efficacy. Consequently, this support can lead to increased breastfeeding rates [8]. The “Chinese Breastfeeding Influence Factors Survey Report” indicates that the support rates of grandmothers, grandmothers and fathers for breastfeeding in Chinese families was 89.4%, 87.7% and 89.6% [16]. Furthermore, paternal attitudes have a significantly positive effect on maternal adherence to exclusive breastfeeding within the first six months. The incidence of exclusive breastfeeding within this period is markedly greater among mothers who receive paternal support than among those who do not. Additionally, Drysdale’s research findings indicate that women who receive support from their partners are three times more likely to practice exclusive breastfeeding than women in the control group who do not [17]. This observation aligns with the results of the present study and underscores the critical role of paternal support. However, other studies have reported that paternal support interventions do not significantly increase breastfeeding rates, which contrasts with the findings of this study. The discrepancy in these results may be attributed to the unique characteristics of the specific study samples. For example, a study conducted in Australia reported that participants already possessed higher levels of education, health literacy, and a strong predisposition to breastfeed at baseline, potentially diminishing the observable impact of supportive interventions within these cohorts [18]. This indicates that when evaluating the efficacy of paternal support interventions, it is crucial to consider the heterogeneity of the sample population and specific contextual factors. Within the family environment, fathers serve not only as emotional support pillars but also as essential contributors to the practical aspects of parenting. Unlike volunteers and healthcare professionals, fathers, as integral family members, may provide sustained care to mothers during the perinatal period, share parenting responsibilities, and offer emotional support, thereby demonstrating distinct advantages. Research suggests that fathers’ immediate involvement in facilitating skin-to-skin contact and early breastfeeding initiation post-childbirth is critical for the successful commencement of breastfeeding [19]. Koksal’s study highlights that paternal involvement in night-time childcare during the initial phase of breastfeeding facilitates increased rest for mothers, thereby positively influencing maternal recovery and breastfeeding outcomes [15]. Furthermore, research by Rempel et al. demonstrated a significant correlation between paternal emotional support during pregnancy and maternal self-efficacy in breastfeeding, which is instrumental in both the initiation and continuation of breastfeeding [20]. Moreover, extant research has shown that sustained emotional support from fathers is a critical determinant in the maintenance of prolonged breastfeeding [11, 15]. Nonetheless, practical implementation reveals a pronounced deficiency in paternal engagement in breastfeeding practices. This shortfall may be attributed to an amalgamation of factors, including sociocultural influences, gender role stereotypes, insufficient knowledge and education, occupational pressures and time limitations, lack of support and encouragement, communication barriers, and prevalent misconceptions regarding breastfeeding [16]. In numerous cultural contexts, breastfeeding is perceived as an intrinsic maternal responsibility, often leading to the marginalization or diminished significance of paternal roles. Furthermore, fathers may possess limited knowledge regarding the critical importance of breastfeeding and the ways in which they can provide support. This knowledge gap is frequently exacerbated by insufficient guidance and encouragement from healthcare professionals, societal norms, and familial expectations [21]. Additionally, occupational demands and time constraints constitute significant factors that influence the extent of paternal involvement. As the father is often the primary economic providers for their families, they encounter the challenge of balancing professional and familial responsibilities, particularly when paternity leave is limited. This constraint can result in reduced long-term involvement in breastfeeding practices [8]. Additionally, communication barriers and misconceptions surrounding breastfeeding may further impede fathers’ active participation in this aspect of childcare [20]. To address these challenges, future research should consider practical factors and collaborate with health organizations to develop intervention programs that more effectively meet the needs of the target population [16]. This may encompass the provision of education and training, the enhancement of fathers’ comprehension regarding the significance of breastfeeding, and the offering of practical support and resources to assist fathers in overcoming barriers to their participation in breastfeeding. Such interventions can increase the degree of paternal involvement in breastfeeding, thereby fostering a more supportive and conducive environment for both mothers and infants.

Research has substantiated the pivotal role of paternal support in promoting breastfeeding. However, on a global scale, particularly in developing countries, fathers often do not fully acknowledge the importance of their support in breastfeeding due to various impediments emanating from the health system, social environment, and personal factors. Additionally, there are notable disparities in intervention strategies and economic investments aimed at supporting breastfeeding across different regions. A UNICEF report indicates that only 15 countries worldwide have implemented three essential national policies to support family parenting [22]. Among these policies is the provision of four weeks of paid paternity leave for fathers, which facilitates their involvement in parenting and breastfeeding support. It is concerning that the majority of countries presently fail to acknowledge the critical role of fathers in breastfeeding support, thereby hindering the delivery of comprehensive breastfeeding assistance.

A study indicates that within the Syrian refugee community, breastfeeding decisions are predominantly made by mothers, with minimal paternal involvement and inadequate financial and practical support [23]. This affects maternal health and breastfeeding. Enhancing economic and social support, along with tailored policies for refugees, could boost family planning and create a more breastfeeding-friendly environment. In Vietnam, breastfeeding support initiatives frequently manifest as community-based activities aimed at fathers within regional contexts [24, 25]. Conversely, in China, interventions predominantly emphasize in-hospital care for mothers, supplemented by online follow-up post-discharge [10,11,12,13,14]. In developed nations such as Australia, multicenter and multi-institutional collaborative projects advance paternal support for breastfeeding through the development of targeted applications, such as Milk Man, thereby offering fathers a more accessible support environment [18]. These differences suggest that the efficacy of interventions may differ substantially across regions. Consequently, addressing the breastfeeding gap is important, future research should consider local socioeconomic conditions and cultural contexts when designing and implementing breastfeeding support interventions to ensure their effectiveness and adaptability.

Although this study provides compelling evidence regarding the impact of paternal support interventions on breastfeeding outcomes, we acknowledge certain limitations that must be addressed in subsequent research: ① Scope of the literature search: This study is confined to the retrieval of publicly available literature in Chinese and English, potentially excluding research findings in other languages or unpublished results, which may impact the comprehensiveness of the literature review. ② Assessment of literature quality: The eight included studies were all evaluated as Grade B, suggesting that while the research findings possess a certain level of reliability, there remains substantial scope for enhancement in the overall quality of the literature. ③ Heterogeneity issues: Despite the heterogeneity test indicating minimal heterogeneity among the study results, potential clinical and methodological variations across different studies may still influence the interpretation of the findings. ④ Limitations of evaluation indicators: The evaluation indicators utilized in the literature are not sufficiently comprehensive, omitting critical measures such as breastfeeding self-efficacy and neonatal growth and development. Furthermore, owing to data constraints, an in-depth exploration of the specific mechanisms was not feasible.